A right-angle clamp was insinuated between the hypertrophied cricopharyngeus and the submucosa. Division of this muscle is the critical step in correcting the physiological abnormality. The sac may be left intact if it is small.
Cricopharyngeal myotomy was performed. A more recent alternative to open myotomy is per-oral endoscopic division of the cricopharyngeus using a 30mm linear stapler. This simultaneously opens the sac into the esophagus. The length of this sac (5cm) was the reason an open approach was used.
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